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MaddieClaire: Have been on Paxil for over 30 years.


MaddieClaire

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Posted (edited)

I have been on Paxil or other SSRI's since my 20's for Major Depression and Anxiety, now  I am in my mid-60's.  Have tried different SSRI's, SNRI, Effexor, Lamotragine, , Celexa etc, but they all have serious sexual side-effects. Wellbutrin did not work for me. I have attempted to wean off  3 or 4 times in the past 40 years and have had to go back on. I realize after reading your forum that I did not take long enough to taper. 

 

I am going to retire in September from a very stressful job at a hospital. I will see my Psychiatrist next month, but have already weaned down from 10 mg Paxil to 5 mg tablets over the last 2 months. Initially I had some headache, and queasy stomach but no longer. My question is how do I accurately measure for tapering by 10% of a 5 mg tablet and so on. I don't think my insurance pays for liquid Paxil as we tried that before.  I have a digital scale but I don't think it is accurate for such tiny amounts. Is there a way to crush half a pill and mix with water and figure out how many drops I should take? 

 

Since I have been SSRI's for so long, should I decrease by 10% every 3 months, or what time-frame is recommended. The biggest reason i want to come off is because of the sexual side effects. I have felt cheated for most of my adult life and now that I am nearing retirement, I want to heal my body. 

Edited by Emonda
Name to title

 Trying to Taper off Paxil now at 5 mg. How to make accurate dose with tablets. 

1996 Paroxetine 10 mg

1997 Added Bupropion  Tried Mirtazapine, St.Johns Wart, Aprazolam and Zolpidem prn

1998 Nefazodone for 9 moths

1999 Buspirone, Citalopram 30 mg

2000Tapered off Citalopram, tried non-prescrition options 5-HTP

2002 Low dose Venlafaxine XL and Buspirone

2010  Desvenlafaxine, 2 month trial Sertaline with Quetiapine 200 mg,Paroxetine 10 mg, Quetiapine 200-300 

2012-2018 Paroxetine10 mg. Add Wellbutrin and 200 mg Quetiapine,2018 Tapered off Paroxetine 20% at a time, continued 200 mg Quetiapine

2019- March 2024 Paxil 10 mg. Switched from Quetiapine to Trazadone 100 mg

April -May 2024 tapered down to Paxil 5 mg + 100 mg Trazadone

 

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  • Emonda changed the title to MaddieClaire: Have been on Paxil for over 30 years.
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Welcome @MaddieClaire

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8 hours ago, MaddieClaire said:

I have attempted to wean off  3 or 4 times in the past 40 years and have had to go back on. I realize after reading your forum that I did not take long enough to taper. 

Why taper by 10% of my dosage? The reductions should get smaller and smaller each month, for example: 10mg, 9mg, 8.1mg, 7.3mg etc. Importantly, if you develop unpleasant side effects from tapering, halt the taper, give yourself time to settle, and once stable, taper more slowly and by smaller amounts moving forward.

If you taper faster than this, then WD symptoms are the likely outcome: Daily Checklist of Antidepressant Withdrawal Symptoms (PDF) 

8 hours ago, MaddieClaire said:

have already weaned down from 10 mg Paxil to 5 mg tablets

I'd refer back to the link about tapering at a maximum of 10%...10mg to 5mg over two months is too fast. Whilst you may feel stable now, it can catch up with you down the track.

8 hours ago, MaddieClaire said:

My question is how do I accurately measure for tapering by 10% of a 5 mg tablet and so on. I don't think my insurance pays for liquid Paxil as we tried that before.  I have a digital scale but I don't think it is accurate for such tiny amounts. Is there a way to crush half a pill and mix with water and figure out how many drops I should take? 

I know of another member here taking the same AD at a similar dose that has success with this: A&D EJ-54D2 Dual Range - 22g x 0.0002g / 52g x 0.001g Compact Balance.

Others crush their tablet, mix it with water, shake vigorously, then remove the unwanted amount with a 0.5ml syringe and taper that way. Not all ADs can be crushed/mixed with water however.

8 hours ago, MaddieClaire said:

I don't think my insurance pays for liquid Paxil as we tried that before

Great care needs to be taken when Transitioning from pills to liquid

8 hours ago, MaddieClaire said:

Since I have been SSRI's for so long, should I decrease by 10% every 3 months

We all respond differently. Slow is the way to go. My AD career  🤨 is a similar length to yours, and I follow this approach: The Brassmonkey Slide Method of Micro-tapering. It works for me.

A few more helpful links:

Windows and waves pattern of stabilization

Emotional Spirals

Non-drug coping strategies

Melatonin for sleep

We don't suggest many supplements, but two that many of us find helpful are magnesium and omega-3 fish oil. Here are the links for info about those. Add one at a time and start with a low dose to see how it affects you.

Omega-3 fatty acids (fish oil) and Magnesium

Avoid alcohol.

Don't change the manufacturer of your AD.

This is your own Introduction topic.  Each member has only ONE Introduction topic.  Your own Introduction topic is the best place to ask questions and the place to journal your progress.  This keeps your history in one place and means you do not have to repeat your story. 

Once again, welcome to S.A.

Emonda

Please don't send me PMs. I am not a doctor. My comments are based on my personal experience with ADs and tapering. Consult your doctor about your own medical decisions.

Start of taper: Jan ’22 Vortioxetine 15mg, 

End year 1: 4.5mg, 

End year 2: 2.38mg, 

Year 3: 19 Jan 2.33mg, 26 Jan 2.28mg, 2 Feb 2.24mg, 8 Feb 2.19mg, 29 Feb 2.15mg, 7 Mar 2.10mg, 14 Mar 2.06mg, 21 Mar 1.99mg, 10 Apr 1.95mg, 17 Apr 1.91mg, 24 Apr 1.87mg, 1 May 1.83mg, 23 May 1.80mg, 30 May 1.76mg, 8 Jun 1.72mg, 13 Jun 1.66mg, 3 Jul 1.62mg, 10 Jul 1.58mg, 17 Jul 1.54mg

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Posted (edited)

I am really bad at math. If I were to taper by 10% every month let's say I start at 5 mg.

5mg

4.5

4.05

3.645

3.2805

How can I possibly measure that amount of a tablet?  The liquid suspension method seems a little easier but I am still confused. If I cut 5mg into quarters and dissolve it for 2 hours in 5 mg of water, then I am not sure how much to take each day through the syringe? I don't think I can figure it out.

Edited by MaddieClaire
grammatically incorrect

 Trying to Taper off Paxil now at 5 mg. How to make accurate dose with tablets. 

1996 Paroxetine 10 mg

1997 Added Bupropion  Tried Mirtazapine, St.Johns Wart, Aprazolam and Zolpidem prn

1998 Nefazodone for 9 moths

1999 Buspirone, Citalopram 30 mg

2000Tapered off Citalopram, tried non-prescrition options 5-HTP

2002 Low dose Venlafaxine XL and Buspirone

2010  Desvenlafaxine, 2 month trial Sertaline with Quetiapine 200 mg,Paroxetine 10 mg, Quetiapine 200-300 

2012-2018 Paroxetine10 mg. Add Wellbutrin and 200 mg Quetiapine,2018 Tapered off Paroxetine 20% at a time, continued 200 mg Quetiapine

2019- March 2024 Paxil 10 mg. Switched from Quetiapine to Trazadone 100 mg

April -May 2024 tapered down to Paxil 5 mg + 100 mg Trazadone

 

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 Please Explain, I have no idea what this means. Thank you.

 

"I know of another member here taking the same AD at a similar dose that has success with this: A&D EJ-54D2 Dual Range - 22g x 0.0002g / 52g x 0.001g Compact Balance."

 

 

 

 Trying to Taper off Paxil now at 5 mg. How to make accurate dose with tablets. 

1996 Paroxetine 10 mg

1997 Added Bupropion  Tried Mirtazapine, St.Johns Wart, Aprazolam and Zolpidem prn

1998 Nefazodone for 9 moths

1999 Buspirone, Citalopram 30 mg

2000Tapered off Citalopram, tried non-prescrition options 5-HTP

2002 Low dose Venlafaxine XL and Buspirone

2010  Desvenlafaxine, 2 month trial Sertaline with Quetiapine 200 mg,Paroxetine 10 mg, Quetiapine 200-300 

2012-2018 Paroxetine10 mg. Add Wellbutrin and 200 mg Quetiapine,2018 Tapered off Paroxetine 20% at a time, continued 200 mg Quetiapine

2019- March 2024 Paxil 10 mg. Switched from Quetiapine to Trazadone 100 mg

April -May 2024 tapered down to Paxil 5 mg + 100 mg Trazadone

 

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  • Mentor
Posted (edited)
4 hours ago, MaddieClaire said:

 Please Explain, I have no idea what this means. Thank you.

 

"I know of another member here taking the same AD at a similar dose that has success with this: A&D EJ-54D2 Dual Range - 22g x 0.0002g / 52g x 0.001g Compact Balance."

 

I guess it is the scale model that the other member uses and has success with.

 

5 hours ago, MaddieClaire said:

5mg

4.5

4.05

3.645

3.2805

How can I possibly measure that amount of a tablet? 

I understand your worries. Depending on the accuracy of your scale it is not possible. I think scales for about $50 have an accuracy of 0.4mg.

It is more important to be precise than accurate though. This means the way that you dose should consistently return the same amount of active ingredient (precision) and it is not so important to know exactly how much that is (accuracy). The reason for this is that it is more important to listen to your body and to observe yourself while tapering than to stick to some mathematical plan. So probably there are methods where you reduce your dose very precisely and use the scale only to know approximately where you are. Unfortunately I don't know more about this in the case of Paxil.

 

I would search this forum for members that have a lot of experience tapering Paxil at low doses. You can then tag them like this @MaddieClaire and invite them into your thread and ask how they are doing it and what they think.

 

Getting a precise and accurate amount of active ingredient is easier using a liquid (homemade solution/suspension). However, there are also drawbacks using a liquid. Some people don't tolerate homemade liquids that well and you cannot prepare your doses ahead of time and store them. 

 

Here is a thread that deals with this subject in the case of Paxil:

https://www.survivingantidepressants.org/forums/topic/405-tips-for-tapering-off-paxil-paroxetine/#comment-4141

 

Edited by Alfred1977

Earlier drug history:

Paroxetine  2001 until 2003, quit cold turkey, don't remember dose; Venlafaxine 2005 until Dez. 2023, mostly 75mg xr per day, for about 4 years 37.5mg xr; quite a lot of Antihistamines because of allergy; there were other drugs that I don't remember all, but nothing what I consistently took over a longer period of time, for example Lorazepam 0.5mg prn.

Recent developments:

Dez 2023 - 03/13/2024 quitting Venlafaxine 75mg (skipping doses); 04/07/2024 reinstating Venlafaxine 12,5mg; 04/17/2024 Venlafaxine 25mg; 4/29/24 until 5/4/24 Trimipramine, 5mg going down to zero over 5 days

Drugs right now:

Venlafaxine 25mg; supplements: 500mg magnesium, 100mg aspirin and melatonin spray

 

I am no medical expert. I am dependent on Venlafaxine, trying to find and give peer support in this community and simply giving my opinion. Double check any information before you take action, for example with your doctor.

 

First they sell addictive drugs as harmless and then they leave you alone dosing fractions of a mg correctly or plunging into the abyss.

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  • Administrator
4 hours ago, MaddieClaire said:

Please Explain, I have no idea what this means. Thank you.

 

4 hours ago, MaddieClaire said:

A&D EJ-54D2 Dual Range - 22g x 0.0002g / 52g x 0.001g Compact Balance.

 

It is a digital scale you can purchase on Ebay: https://www.ebay.com/itm/275185411474

 

Another member on this site uses this scale and speaks highly of it. They are tapering off Paxil as well.

Please don't send me PMs. I am not a doctor. My comments are based on my personal experience with ADs and tapering. Consult your doctor about your own medical decisions.

Start of taper: Jan ’22 Vortioxetine 15mg, 

End year 1: 4.5mg, 

End year 2: 2.38mg, 

Year 3: 19 Jan 2.33mg, 26 Jan 2.28mg, 2 Feb 2.24mg, 8 Feb 2.19mg, 29 Feb 2.15mg, 7 Mar 2.10mg, 14 Mar 2.06mg, 21 Mar 1.99mg, 10 Apr 1.95mg, 17 Apr 1.91mg, 24 Apr 1.87mg, 1 May 1.83mg, 23 May 1.80mg, 30 May 1.76mg, 8 Jun 1.72mg, 13 Jun 1.66mg, 3 Jul 1.62mg, 10 Jul 1.58mg, 17 Jul 1.54mg

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9 hours ago, MaddieClaire said:

I am really bad at math. If I were to taper by 10% every month let's say I start at 5 mg.

5mg

4.5

4.05

3.645

3.2805

How can I possibly measure that amount of a tablet?  The liquid suspension method seems a little easier but I am still confused. If I cut 5mg into quarters and dissolve it for 2 hours in 5 mg of water, then I am not sure how much to take each day through the syringe? I don't think I can figure it out.

Hi Maddie, after fully stabilising on current drop you can dissolve 5mg of paxil in 10ml of water. Then store in amber glas jar in fridge for max 3 days. Using a tiny 1 and 2 ml sirringe (from pharmacie) you can subtract micro doses for example from 5.0 to 4.8 mg in 1 month and then 2 week hold. 

Or even better microtaper weekly for 4 weeks.

 

10 ml contains 5 mg, that means 1 ml = 0.5 mg and 0.2 ml = 0.1 mg. This way you can keep using the same tablet that you have been using all along. That would be wiser thant switching or rather transitioning to retail liquid. Read links above for more detailed info.

 

But first hold longer for stability like Emonda said this last drop may catch up with you.

  • 456 years old male
  • job in spatial planning
  • into sports, animals and nature
  • Started using 20 mg Paroxetine (Paxil) in 2004 for stressrelated anxiety/depression
  • Attempted several times to stop, starting a few years after 2004
  • Found out in 2015 about paxil withdrawal symptoms and the 5-10% taper guideline
  • Started using liquid paxil in 2015/2016
  • 2018 --> 11.2 mg of paxil
  • 2019-2023 developed severe food- and other sensitivities (anti imflammatory, anti oxidant, food colourings, oils, herbs, chemicals etc.)
  • 12/2023 Had been building up for 4 years to Poop-out/tolerance, introducing brassmonkey slide method 0.1mg/week
  • 26/1/2024 10 mg (journey halfway).
  • 14/7/2024 8.4 mg
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  • Mentor
51 minutes ago, Sebas said:

Hi Maddie, after fully stabilising on current drop you can dissolve 5mg of paxil in 10ml of water. Then store in amber glas jar in fridge for max 3 days. Using a tiny 1 and 2 ml sirringe (from pharmacie) you can subtract micro doses for example from 5.0 to 4.8 mg in 1 month and then 2 week hold. 

Or even better microtaper weekly for 4 weeks.

 

10 ml contains 5 mg, that means 1 ml = 0.5 mg and 0.2 ml = 0.1 mg. This way you can keep using the same tablet that you have been using all along. That would be wiser thant switching or rather transitioning to retail liquid. Read links above for more detailed info.

 

But first hold longer for stability like Emonda said this last drop may catch up with you.

Thanks a lot for helping. Is paroxetine solvable in water? Or will it be a suspension that you have to shake or stir before use?

Earlier drug history:

Paroxetine  2001 until 2003, quit cold turkey, don't remember dose; Venlafaxine 2005 until Dez. 2023, mostly 75mg xr per day, for about 4 years 37.5mg xr; quite a lot of Antihistamines because of allergy; there were other drugs that I don't remember all, but nothing what I consistently took over a longer period of time, for example Lorazepam 0.5mg prn.

Recent developments:

Dez 2023 - 03/13/2024 quitting Venlafaxine 75mg (skipping doses); 04/07/2024 reinstating Venlafaxine 12,5mg; 04/17/2024 Venlafaxine 25mg; 4/29/24 until 5/4/24 Trimipramine, 5mg going down to zero over 5 days

Drugs right now:

Venlafaxine 25mg; supplements: 500mg magnesium, 100mg aspirin and melatonin spray

 

I am no medical expert. I am dependent on Venlafaxine, trying to find and give peer support in this community and simply giving my opinion. Double check any information before you take action, for example with your doctor.

 

First they sell addictive drugs as harmless and then they leave you alone dosing fractions of a mg correctly or plunging into the abyss.

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Thank you Sebas. I think I understand. A few more questions. "10 ml contains 5 mg, that means 1 ml = 0.5 mg and 0.2 ml = 0.1 mg." 

 

 

If I take the  entire 10 ml I will be getting  5 mg. If I taper by 10%, my next dose would be 9 ml? Then after that do I have to do 10% of 9 ml? Which is 9.1 ml? then 10% of 9.1 which is .91 and I subtract it from 9.1 so my next taper would be 8.19? Could you show me how to do the math on the next 3 tapers or are my calculations correct.

 

thanks, MaddieC

 Trying to Taper off Paxil now at 5 mg. How to make accurate dose with tablets. 

1996 Paroxetine 10 mg

1997 Added Bupropion  Tried Mirtazapine, St.Johns Wart, Aprazolam and Zolpidem prn

1998 Nefazodone for 9 moths

1999 Buspirone, Citalopram 30 mg

2000Tapered off Citalopram, tried non-prescrition options 5-HTP

2002 Low dose Venlafaxine XL and Buspirone

2010  Desvenlafaxine, 2 month trial Sertaline with Quetiapine 200 mg,Paroxetine 10 mg, Quetiapine 200-300 

2012-2018 Paroxetine10 mg. Add Wellbutrin and 200 mg Quetiapine,2018 Tapered off Paroxetine 20% at a time, continued 200 mg Quetiapine

2019- March 2024 Paxil 10 mg. Switched from Quetiapine to Trazadone 100 mg

April -May 2024 tapered down to Paxil 5 mg + 100 mg Trazadone

 

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12 hours ago, MaddieClaire said:

5mg

4.5

4.05

3.645

3.2805

How can I possibly measure that amount of a tablet? 

Tablets have filler in them so the weight will be higher than the actual weight of the drug. It is important to stick with the same manufacturer when tapering. Different manufacturers use slightly different formulations and drug amounts. 

When doing calculations that involve numerous decimals, you always round up. 5 mg, 4.5 mg, 4.1 mg, 3.7 mg, 3.3 mg.

12 hours ago, MaddieClaire said:

If I cut 5mg into quarters and dissolve it for 2 hours in 5 mg of water

Big caution - you cannot cut the pill in quarters and assume your cuts are accurate. It is important to weigh the pill for accuracy. If you have been eyeballing your cut so far, I would strongly recommend to start weighing it so that you are getting even quarters.

It is easier to do your own liquid but I would hold for a solid 3 months to make sure you have no bad withdrawal from this last drop. Then if you are in the clear, you need to slowly transition to homemade liquid.

Read this link carefully 

 

 

 

2016-twice weekly for a couple months-oxazepam 10 mg sleep/ 2020-22-once a week 3.75-7.5 mg for sleep/20 yr+ Paroxetine/ Dec2018-May 2022 20 mg/ May 2022 30mg/2022.07.28-2022.08.24 30mg to 0mg/ August 24-29 2022 10mg Prozac/2022.11.28-2022.12.04- 5mg Paroxetine/Dec 5&6/22 10mg Paroxetine/ Dec 8&9/22 10mg Prozac/ 2022.12.07 to 2023.07.01 5mg Paroxetine

TAPER 23.07.02-58mgpw/4.9mgai/ 23.07.21-4.8 mg/23.07.28-4.73 mg/23.08.04-4.65 mg/21.09.23-4.58 mg/27.10.23-4.56 mg/5.12.23-4.54 mg/2.1.24-4.52 mg/9.1.24-4.51 mg/17.1.24-4.49 mg/26.1.24-4.47 mg/6.2.24-4.46 mg/19.2.24-4.44mg /4.4.24-4.43mg/28.4.24-4.4mg/5.5.24-4.39 mg/19.5.24-4.36 mg/2.7.24-4.34 mg/9.7.24-4.32 mg

8am-probiotics/9am-paroxetine, 200mg mag bisglycinate/ 1000mg Vitamin D/5pm-75 mg DGL/200mg calcium citrate/0.25 mcg melatonin nightly

"... your strength will be in keeping calm..."-Isaiah 30:15

I am not a medical professional just your peer. The suggestions I give are based on personal experience and/or the well documented experience of others.

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4 hours ago, Alfred1977 said:

Thanks a lot for helping. Is paroxetine solvable in water? Or will it be a suspension that you have to shake or stir before use?

It's a combination. You dissolve it in water then leave it for at least a couple of hours until the main substance is equally divided throughout the water, then you shake/stirr before you subtract. The glass has to be amber or dark due to the influence of light on the meds.

  • 456 years old male
  • job in spatial planning
  • into sports, animals and nature
  • Started using 20 mg Paroxetine (Paxil) in 2004 for stressrelated anxiety/depression
  • Attempted several times to stop, starting a few years after 2004
  • Found out in 2015 about paxil withdrawal symptoms and the 5-10% taper guideline
  • Started using liquid paxil in 2015/2016
  • 2018 --> 11.2 mg of paxil
  • 2019-2023 developed severe food- and other sensitivities (anti imflammatory, anti oxidant, food colourings, oils, herbs, chemicals etc.)
  • 12/2023 Had been building up for 4 years to Poop-out/tolerance, introducing brassmonkey slide method 0.1mg/week
  • 26/1/2024 10 mg (journey halfway).
  • 14/7/2024 8.4 mg
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2 hours ago, MaddieClaire said:

Thank you Sebas. I think I understand. A few more questions. "10 ml contains 5 mg, that means 1 ml = 0.5 mg and 0.2 ml = 0.1 mg." 

 

 

If I take the  entire 10 ml I will be getting  5 mg. If I taper by 10%, my next dose would be 9 ml? Then after that do I have to do 10% of 9 ml? Which is 9.1 ml? then 10% of 9.1 which is .91 and I subtract it from 9.1 so my next taper would be 8.19? Could you show me how to do the math on the next 3 tapers or are my calculations correct.

 

thanks, MaddieC

The math is correct but i would advice to try 5% first. Only few people can taper paxil as fast as 10% and most use microtapering or even less then 5%. Its better to go too slow then too fast.

  • 456 years old male
  • job in spatial planning
  • into sports, animals and nature
  • Started using 20 mg Paroxetine (Paxil) in 2004 for stressrelated anxiety/depression
  • Attempted several times to stop, starting a few years after 2004
  • Found out in 2015 about paxil withdrawal symptoms and the 5-10% taper guideline
  • Started using liquid paxil in 2015/2016
  • 2018 --> 11.2 mg of paxil
  • 2019-2023 developed severe food- and other sensitivities (anti imflammatory, anti oxidant, food colourings, oils, herbs, chemicals etc.)
  • 12/2023 Had been building up for 4 years to Poop-out/tolerance, introducing brassmonkey slide method 0.1mg/week
  • 26/1/2024 10 mg (journey halfway).
  • 14/7/2024 8.4 mg
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